Hypertension in China: Past, Present, and Future

Since 1958 multiple national surveys have been carried out to estimate the prevalence of hypertension in China. With each passing decade the prevalence of hypertension rose significantly (5-11%, 7.7%, 11%, and 24-27%, respectively for 1958, 1979-1980, 1991 and 2000). An obvious trend emerged in the 1980s that prevalence increases from southern (23%) to northern (33%) parts of China. A then popular concept that prevalence of hypertension is lower in rural area of China due to poor living conditions no longer held true. Urbanization and industrialization are rapidly catching up in the rural areas as well. Interestingly, the northern Liaoning province (considered to be rural China) has a hypertension awareness of 27%. It is significantly lower than the Chinese national rates of 43% and U.S. national rate of 73%. The combination of low education along with sedentary lifestyle and prevalence of a diet rich in salt and fat predispose the rural population to a high risk for hypertension. Furthermore, there is a significantly higher relative risk for stroke in Chinese hypertensive patients than Caucasian. A 5 mmHg increase in blood pressure increases the risk of coronary heart disease by 27% and stroke by 46% in Chinese and Japanese populations. By treating 1000 hypertensive patients for 5 years, one could prevent 39 strokes, 59 major cardiovascular complications and 55 deaths. Promoting public awareness of hypertension and healthy life style choices (especially in rural areas of China) should be on the top of China's public health agenda.